Preceptoria médica: percepções e perspectivas de novos médicos de família no Brasil

Ferreira, Iago Gonçalves; Cazella, Silvio César; Costa, Márcia Rosa da

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Revista Brasileira de Educação Médica

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ORIGINAL ARTICLE • Rev. bras. educ. med. 47 (02) • 2023 • https://doi.org/10.1590/1981-5271v47.2-20220299.ING copiar

Preceptoria médica: percepções e perspectivas de novos médicos de família no Brasil

Autoria SCIMAGO INSTITUTIONS RANKINGS

Resumo:

Introdução:

O aprendizado em ambientes práticos consiste em um componente essencial da educação médica. Nas últimas décadas, as escolas médicas têm procurado imergir os estudantes em ambientes profissionais desde os primeiros anos do curso. Nesses cenários, médicos mais experientes, preceptores, são responsáveis por apoiar seus aprendizes no desenvolvimento de conhecimentos, habilidades e atitudes profissionais.

Objetivo:

Este estudo teve como objetivo analisar as percepções e perspectivas de participantes do curso de Especialização em Preceptoria em Medicina de Família - UNA-SUS sobre preceptoria e educação médica.

Método:

O estudo quantitativo descritivo foi realizado em duas fases: “delineamento da população”, que incluiu dados acadêmicos dos participantes, e “questionário de pesquisa”, em que se aplicou um questionário por meio de uma plataforma digital.

Resultado:

O “delineamento da população” identificou 2.530 participantes do curso de Especialização, com predominância do sexo feminino e moradores da Região Sudeste. A fase “questionário da pesquisa” foi composta por 232 respondentes, dos quais 73,4% relataram reconhecer as contribuições de seus preceptores, e mais de 90% manifestaram interesse em atividades de ensino, valorizando sua valorização curricular e seu reconhecimento acadêmico.

Conclusão:

Nossos achados evidenciaram percepções positivas sobre a preceptoria e a propensão ao engajamento em atividades docentes dos participantes, reforçando a importância de debates sobre qualificação, recrutamento e retenção de preceptores.

Palavras-chave:
Preceptoria; Medicina de Família; Internato e Residência; Educação Médica

Population Outlining - Phase 1
Course editions	n	%
First Edition (2016-2018)	974	38.5
Second Edition (2018-2020)	847	33.5
Third Edition (2019-2021)	709	28.0
Age
Mean	33.21
SD	5.58
Minimum	26
Maximum	77
Gender	n	%
Male	875	33.2
Female	1655	66.8
Regions	n	%
North	225	6.9
Northeast	467	16.4
Midwest	198	6.9
Southeast	1237	45.7
South	403	24.1
Total	2530	100.0
Survey Questionnaire - Phase 2
Course editions	n	%
First Edition (2016-2018)	60	25.9
Second Edition (2018-2020)	85	36.6
Third Edition (2019-2021)	87	37.5
Age
Mean	32.43
SD	6.40
Minimum	26
Maximum	77
Gender	n	%
Male	77	33.2
Female	155	66.8
Regions	n	%
North	16	6.9
Northeast	38	16.4
Midwest	16	6.9
Southeast	106	45.7
South	56	24.1
Total	232	100.0

Satisfaction with FM residency programs
Scale of satisfaction					n		%
Totally dissatisfied				1	12		5.2
Dissatisfied				2	11		4.7
Partially satisfied				3	57		24.6
Satisfied				4	98		42.2
Very satisfied				5	51		22.0
Total					229		100.0
Regions ^* *The Scheffé Post-Hoc Test evidenced a significant difference between the regions regarding the satisfaction with the FM residency programs, demonstrating a higher degree of satisfaction in the South region compared to the Northeast region (p= 0.036; 95%CI = 0.028 - 1.357). The set of regions showed a tendency towards stratification (South > Southeast > Midwest > North > Northeast).	n	$\bar{x}$	SD	CI (95%)	H		p
North	15	3.60	0.73	3.20 - 4.0	13.80		0.008
Northeast	38	3.29	1.06	2.940 - 3.639
Midwest	16	3.56	1.15	2.948 - 4.177
Southeast	105	3.78	1.07	3.573 - 3.989
South	55	3.98	0.87	3.746 - 4.217
Institutions ^ The Scheffé Post-Hoc Test evidenced a significant difference between the spheres of the institutions regarding the satisfaction with the FM residency programs, demonstrating a higher degree of satisfaction in federal institutions compared to private / philanthropic institutions (p= 0.026; CI 95%: 0.052 - 1.217), being higher in municipal institutions than in private / philanthropic institutions (p= 0.008; 95%CI: 0.114 - 1.099).	n	$\bar{x}$	SD	CI (95%)	H		p
Federal	44	3.95	0.83	3.70 - 4.21	13.02		0.005
State	40	3.47	1.03	3.14 - 3.80
Municipal	95	3.92	0.93	3.73 - 4.11
Philanthropic / Private	50	3.32	1.20	2.98 - 3.66
Total	229	3.72	1.03	3.58 - 3.85
Perceptions of preceptors’ contributions
Scale of perception					n		%
Totally irrelevant		1			5		2.2
Little relevant		2			17		7.4
Partially relevant		3			39		17.0
Sufficiently relevant		4			102		44.3
Totally relevant		5			67		29.1
Total					230		100.0
Institutions ^* *The Scheffé Post-Hoc Test evidenced a significant difference between the spheres of the institutions regarding the perception of the preceptors’ contributions, demonstrating a greater degree in federal institutions in comparison to state institutions (p = 0.007; CI 95% = 0.143 - 1.298) and private / philanthropic institutions (p = 0.004; CI 95% = 0.169 - 1.262), and higher in municipal institutions than in private / philanthropic institutions (p = 0.049; CI 95% = 0.001 - 0.923). The spheres of the institutions showed a tendency towards stratification (Federal > Municipal > Philanthropic / Private > State).		n		$\bar{x}$	SD	CI (95%)	H	p
Federal		44		4.29	0.70	4.08 - 4.51	15.74	0.001*
State		40		3.57	1.19	3.19 - 3.95
Municipal		96		4.04w	0.84	3.87 - 4.21
Philanthropic / Private		50		3.58	1.05	3.28 - 3.88
Total		230		3.91	0.97	3.78 - 4.03

Preceptorship training programs and experiences
		1 ^st edition		2 ^nd edition		3 ^rd edition		Total		X²	p ^* * Pearson’s Chi-square Test
		%	n	%	n	%	n	%	n	X²	p ^* * Pearson’s Chi-square Test
Preceptorship with students	Yes	41	68.3	45	52.9	42	48.8	128	55.4	5.77^* * Pearson’s Chi-square Test	0.056^* * Pearson’s Chi-square Test
Preceptorship with students	No	19	31.7	40	47.1	44	51.2	103	44.6	5.77^* * Pearson’s Chi-square Test	0.056^* * Pearson’s Chi-square Test
Preceptorship with beginner residents	Yes	51	85.0	74	87.1	73	84.9	198	85.7	0.20^* * Pearson’s Chi-square Test	0.90^* * Pearson’s Chi-square Test
Preceptorship with beginner residents	No	9	15.0	11	12.9	13	15.1	33	14.3	0.20^* * Pearson’s Chi-square Test	0.90^* * Pearson’s Chi-square Test
Preceptorship training programs^ Preceptorship training programs offered by FM residency programs.	Yes	40	66.7	40	48.2	44	52.4	124	54.6	5.06^* * Pearson’s Chi-square Test	0.08^* * Pearson’s Chi-square Test
	No	20	33.3	43	51.8	40	47.6	103	45.4	5.06^* * Pearson’s Chi-square Test	0.08^* * Pearson’s Chi-square Test
Total								231	100.0
Influence of preceptorship experiences
Interest in teaching activities ^* * Pearson’s Chi-square Test
		Yes		No		X²	p	OR	95%CI
		%	n	%	n	X²	p	OR	Minimum	Maximum
Preceptorship with students	Yes	191	96.5	7	3.5	11.42	< 0.001	6.06	1.89	19.39
Preceptorship with students	No	27	81.8	6	18.2	11.42	< 0.001	6.06	1.89	19.39
Preceptorship with beginner residents	Yes	121	97.6	3	2.4	5.53	0.02	4.33	1.16	16.20
Preceptorship with beginner residents	No	93	90.3	10	9.7	5.53	0.02	4.33	1.16	16.20
Preceptorship training programs^ Preceptorship training programs offered by FM residency programs.	Yes	123	96.1	5	3.9	1.60	0.20	2.07	0.65	6.53
	No	95	92.2	8	7.8	1.60	0.20	2.07	0.65	6.53
Interest in preceptorship at the undergraduate course^ * Pearson’s Chi-square Test*
		Yes		No		X²	p	OR	95%CI
		%	n	%	n	X²	p	OR	Minimum	Maximum
Preceptorship with students	Yes	165	83.3	33	16.7	5.09	0.024	2.50	1.10	5.64
Preceptorship with students	No	22	66.7	11	33.3	5.09	0.024	2.50	1.10	5.64
Preceptorship with beginner residents	Yes	101	81.5	23	18.5	0.00	0.984	0.99	0.50	1.94
Preceptorship with beginner residents	No	84	81.6	19	18.4	0.00	0.984	0.99	0.50	1.94
Preceptorship training programs^ Preceptorship training programs offered by FM residency programs.	Yes	105	82.0	23	18.0	0.21	0.642	1.16	0.60	2.25
	No	82	79.6	21	20.4	0.21	0.642	1.16	0.60	2.25
Interest in preceptorship at medical residency^ * Pearson’s Chi-square Test*
		Yes		No		X²	p	OR	95%CI
		%	n	%	n	X²	p	OR	Minimum	Maximum
Preceptorship with students	Yes	174	87.9	24	12.1	9.90	0.002	3.62	1.56	8.40
Preceptorship with students	No	22	66.7	11	33.3	9.90	0.002	3.62	1.56	8.40
Preceptorship with beginner residents	Yes	117	94.4	7	5.6	20.01	< 0.001	6.24	2.59	15.00
Preceptorship with beginner residents	No	75	72.8	28	27.2	20.01	< 0.001	6.24	2.59	15.00
Preceptorship training programs^ Preceptorship training programs offered by FM residency programs.	Yes	107	83.6	21	16.4	0.35	0.553	0.80	0.38	1.66
	No	89	86.4	14	13.6	0.35	0.553	0.80	0.38	1.66

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